Hrvoje Jednačak

The Effect of Body Position on Intraocular and CSF Pressures in the Lateral Ventricle, and in Cortical and Lumbar Subarachnoid Spaces in Cats

BACKGROUND Correlation between cerebrospinal fluid (CSF) and intraocular pressure (IOP) is still unclear. We compared CSF pressure from different parts of the CSF system and IOP measured by the same invasive technique in a new experimental model in cats during changes of body position. METHODS Pressure changes were recorded on anesthetized cats (n = 7) in the lateral ventricle (LV), in the cortical (CSS) and lumbar (LSS) subarachnoid spaces, and in the anterior ocular chamber. Animals and measuring instruments were both fixed on a board at an adequate hydrostatic level. RESULTS In a horizontal position, IOP (18.5 ± 0.6 cm H(2)O) and CSF pressures (LV = 17.4 ± 0.9; CSS = 17.2 ± 0.7; LSS = 17.8 ± 1.2 cm H(2)O) were similar. In a vertical position, pressure in the LSS increased (33.5 ± 2.3 cm H(2)O), pressures inside the cranial cavity dropped (LV = -4.1 ± 0.9 cm H(2)O; CSS = -4.8 ± 0.5 cm H(2)O), while IOP slightly decreased (14.3 ± 0.1 cm H(2)O). CONCLUSION Change in body position from horizontal to upright causes drastic changes in CSF pressure and relatively small changes in IOP, which indicates that the IOP does not reflect CSF pressure. In an upright position, CSF pressures were equal at the same hydrostatic level in LV and CSS, which suggests that CSF pressure inside the cranium depends on its anatomical and biophysical features, and not on CSF secretion and absorption.

Lipoastrocytoma: A case report

Lipidized tumours of the central nervous system are very rare. Lipidization of tumour cells is a histological hallmark of pleomorphic xanthoastrocytoma and cerebellar neurolipocytoma and has been described in some other primary neuroepithelial tumours such as glioblastoma, cerebral primitive neuroectodermal tumour, central neurocytoma and ependymoma. However, a few cases of lipidized low-grade glial tumours that could not be classified to the fore mentioned categories have been reported, as well. We report a new case of such a tumour occupying the right temporal lobe in a 23-year old woman. Histologically, the tumour was composed of GFAP positive glial cells with areas of complete cell lipidization. More than a two years after the surgery, the patient is well and asymptomatic supporting presumed favourable clinical course of these rare tumours. The recommended treatment plan for these presumably benignant tumours should be continued with radiographic surveillance after the gross total resection.

Rare Infratentorial and Supratentorial Localization of Juvenile Angiofibroma: A Case Report.

Angiofibromas are rare tumors of the head and neck that mostly occur in the sphenopalatine region. We present a case of angiofibroma in a young male patient with an unusual and extremely rare localization, which to our knowledge has not been described before. It was situated in the tentorium and spread to the supratentorial and infratentorial regions. The patient initially presented with symptoms of increased intracranial pressure. After a diagnostic evaluation was done, the whole tumor was successfully removed using the supratentorial and infratentorial approach and the microsurgical technique.